Enrollment in the Program

In order to enroll you first need to schedule and attend an orientation. The day you attend orientation is your enrollment date. If you are ready to schedule an orientation appointment please fill in and submit the form below. If you have questions before enrolling please email at info@alertdrivinginc.com or contact us by phone.

All of the information below is solely used to process your enrollment. Please fill out the form as completely as possible. If you are unsure what to enter in any of the fields please fill in the field as unsure.

Orientation Date Request Form

Program: *

Select the program you are required to attend.

First Name: *

Last Name: *

Street Address: *

City: *

State: *

Zip Code: *

Phone Number: *

Email Address: *

Driver’s License: *

Date of Birth: *

Court (Name of City): *

Violation Date: *

County of Your Arrest:: *

Conviction Date: *

Case Number: *

Comments:

Schedule an Orientation Appointment

You may schedule an orientation appointment in two ways.

1. Fill out the form to the left

Orientations are held on Monday and Wednesday afternoons. You would need to arrive at 3 pm and stay until 5 pm. To this appointment you would bring one of the following: your arrest paperwork, court order or an H-6 in-house printout from the DMV. A down payment of $200 toward the total program is also due at the orientation. If finances are limited you may start with a down payment of $100 and request a financial assessment appointment.

2. Call Alert Driving, Inc.

Contact the office at (408) 879-7581
Monday – Thursday 9 am - 5 pm
Friday 9 am - 4:30 pm